Reference no: EM133380172
Assignment:
1) What are the recommended vaccines for a child 4 months of age? (See https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html for information.)
2) At what age is the MMR vaccination recommended?
3) Why should live, attenuated influenza vaccine (LAIV) not be administered to pregnant women?
4) If a child needs to be vaccinated, and he/she is suffering from mild cold, with slight fever, and cough, will the vaccine still be administered by the healthcare professional?
5) As a healthcare professional, how would you advise a potential traveller to Brazil on vaccinations?
6) Madison Tavistock, a healthy 2-year-old living in Cincinnati, had attended the Wee Folks Daycare Facility for a year. Her parents joined an anti-vaccination group when she was 9 months old, 3 months before the recommended immunization schedule for the MMR vaccine, but after Madison had already been vaccinated with DTP. They strongly believe that the unsubstantiated risk of autism reported for MMR vaccination outweighs the benefits, and consequently have opted not to have their daughter immunized. The best explanation for why Madison has not contracted measles even though she has regular contact with other children in a large city is that.
a. Madison is tolerant to measles antigens.
b. The measles virus may have infected Madison but is dormant.
c. The DTP vaccine provides cross-protective immunity against measles.
d. The other children in the daycare center have been vaccinated and she has herd immunity.
e. The attenuated measles virus in the MMR vaccine received by the other children in her daycare facility was transmitted to Madison and she developed asymptomatic natural immunity.
7) The goal of vaccination is to elicit long-lasting immune memory, in order to mediate protection from infection, or at least to prevent disease in case of exposure to the pathogen. Multiple immunizations are required for most vaccine strategies, to induce efficient protection. Repetitive immunogenic stimulations not only increase the intensity and durability of adaptive immunity, but also influence its quality. Explain this mechanism.
Case Study 1: Emily
Emily is 18 years old and has been in your practice since birth. She is in your facility in May for a routine health visit and vaccinations. She was recently accepted to the state university and will be living in a dormitory when she starts her freshman year in the fall.
Vaccination history:
The immunization registry indicates that Emily completed her childhood vaccines at age 5 years. The only adolescent vaccines she has received are 2 doses of HPV vaccine. Her second dose was administered 1 year ago. She is currently healthy and has no chronic medical conditions.
Emily reports she experienced a syncopal, or fainting, episode after receiving her second dose of HPV vaccine. She was evaluated in the Emergency Department, recovered and discharged without need for treatment.
Your office stocks all routine childhood vaccines as well as T-dap and meningococcal conjugate vaccine. Your plan for today is to administer the last dose of the HPV series and catch up Emily with the other adolescent vaccines, MCV4 and T-dap.
Questions:
Should a pregnancy test be done prior to administering HPV vaccine?
Is Emily's previous history of syncope a contraindication to the vaccines she needs today?
Should HPV vaccine be administered first as a pain management strategy?
Case Study 2: Jason
Jason is a 9 month old who is new to your practice. He is in your facility in November for a routine health visit and vaccinations.
Vaccine history:
The immunization history in the registry shows that he received hepatitis B vaccine at birth. At 4 months of age he received DTAP, IPV and Hib vaccines. He has not received any additional vaccines since then.
His mother reports he was a full-term baby and there were no problems at delivery. Jason is currently healthy and has no chronic medical conditions.
You plan to administer DTaP, IPV, Hep B, Hib, PCV13 and influenza vaccines at this visit. To decrease the number of injections, you want to use a combination vaccine. You have all the routinely recommended pediatric vaccines in your inventory. This particular facility stocks Pentacel- a combination vaccine that includes DTAP, IPV and Hib.
Questions:
Can you use a combination vaccine to catch up Jason since he is behind schedule for several vaccines?
Can you switch from individual vaccines to a combination vaccine?
How should combination vaccines be documented?
General questions about the adaptive immune system:
Define the following terms: antibody idiotype, antibody allotype, and antibody idiotype.
Define class switching.
What is affinity maturation?
Compare and contrast the processing of intracellular antigens and extracellular antigens with subsequent presentation.
What is a superantigen?